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Consulting with Schools on Health Issues
F. HELPING A SCHOOL PREPARE FOR CRISIS
Despite the overwhelming need for a crisis prevention and response plan, many schools remain unprepared. A crisis event often requires a the school to respond to their children's developmental needs during times of crisis and uncertainty. Schools often address each crisis using an informal plan that relies heavily on the immediate decisions of an administrator.
1. Types of Crisis Situations Affecting Schools
Among the many situations that require strong and swift reactions from schools and communities are the following:
- Bereavement because of the death of a student, a staff member, or a community member who is well known to the school community.
- A major environmental crisis that involves the school and community, such as a fire or flood.
- Threats to the physical safety of students, such as a hostage situation or a bomb scare.
2. The Role of the Pediatrician in Crisis Intervention
The pediatrician consulting with schools can help in many ways to prepare the school for crisis:
- Organizing a crisis intervention plan in advance.
- Training staff in crisis intervention.
- Serving as a member of the crisis intervention team, if other commitments allow immediate availability.
- Assisting with crisis follow-up.
3. Crisis Intervention Teams
Pediatricians may become involved by being a member of, or forming, a crisis intervention team. There are many types of intervention teams:
- Regional resource group: persons available to individual school districts for expert consultation and training who can oversee resource needs for the region and coordinate communication between the various school districts regarding training and community services.
- District crisis intervention team: an individual or group who serves as liaison between the Regional Resource Group and the individual school-based crisis team to establish relevant district-wide policy and adapt program models and recommendations of the regional resource group that are consistent with district policies and needs.
- School-based crisis team: consists of school staff members with specific roles who are trained in advance to respond to the needs of the school community.
4. Crisis Team Emergency Procedures
In a crisis, team members could implement the following procedures:
- Share all information known about the crisis, as well as about the immediate response of the school, community, and the student.
- Distribute announcements, and discuss plans for notifying students and parents.
- Encourage staff to ask questions and voice their concerns.
- Remind staff of the crisis intervention model.
- Outline pertinent plans for implementing the crisis intervention (for example, whether support rooms are going to be used) and review any procedural changes (such as school schedule).
- Contact the victim and family members as soon as practically possible to offer support and assistance.
- Ascertain the information that the victim and family wishes to be shared with students, staff, and the media, and clarify or verify any vague information.
- Prepare a written statement about the crisis and distribute to school staff.
- Schedule a follow-up meeting as soon as possible (usually within 24 hours). SLIDE II-19
5. Crisis Intervention and Students
Pediatricians and schools may need to take extra steps to work with students during crisis situations. Some strategies might include the following:
Share a written statement about the crisis with students at a designated time.
- Ensure that all students are present in their classrooms for the statement.
- Provide a written statement to read to parents who call and to send home with students at the end of the day.
Have support rooms available for mental health triage.
- Ensure that support rooms are adequately staffed.
- Keep evaluations brief and goal specific. Children with emergency or urgent mental health needs (such as students assessed as potentially suicidal) should be directly referred to appropriate community resources. Other children may be offered limited immediate interventions, often in a group setting.
Consider needs of the family and students.
- Decide how to convey formally the condolences of the school or class to family survivors.
- Decide how to handle the child's desk or belongings.
- Students should actively participate in the planning of any memorial.
Provide follow-up services.
- Provide long-term services for individual students needing follow-up counseling (school-based support groups are one logical model).
- Conduct a debriefing session several weeks after the crisis to process the reactions of team members.
6. Staff Training in Crisis Management
Pediatricians should have an active role in planning and conducting regional or national workshops or conferences on these topics. Choose a setting that will encourage involvement of representatives of the school system. Staff training should include the following:
- The theory and implementation of crisis intervention
- An understanding of children's and adult's responses to death and other crises
- An understanding of the needs of staff responding to a crisis
- In-depth ongoing training for crisis team members
